Impact of Omalizumab Treatment on Quality of Life and Activity of Chronic Spontaneous Urticaria

Öz

Objective: Omalizumab treatment has shown promise in managing Chronic spontaneous urticaria (CSU). This study focuses on evaluating its effect on improving the quality of life and reducing CSU activity and severity in patients of different age groups. Materials and Methods: Conducted at Derince Training and Research Hospital, this observational study involved 50 CSU patients, categorized into adolescents (≤18years, n=15) and adults (>18years, n=35). Data were collected through clinical and demographic assessments, including Urticaria Activity Score (UAS), Urticaria Control Test (UCT), and Chronic Urticaria Quality of Life Questionnaire (CU-Q2oL) questionnaires, at the beginning and the third month of Omalizumab treatment. Results: Significant improvements were observed in UAS, UCT, and CU-Q2oL scores post-Omalizumab treatment, indicating reduced symptom severity and enhanced quality of life. The median UAS at the start was 35 (28-35); at the third month, 7 (0-7); median UCT at the start was 2 (1.25-3), at the third month 16 (13-16); median CU-Q2oL at the start was 70.5 (66-74), at the third month 23 (23-28); (p<0.001, p<0.001, and p<0.001, respectively). In adult patients, levels of anti-TPO and anti-TG were significantly higher compared to adolescents with CSU (anti-TPO 28 (0.92-47.4) IU/mL vs. 1.73 (0.79-27.1) IU/mL, p=0.066; anti-TG 12.6 (1.4-31.5) IU/mL vs. 1.08 (0.74-9.66) IU/mL, p=0.007). Conclusion: Omalizumab treatment improves the quality of life and reduces disease activity in CSU, demonstrating its efficacy as a therapeutic option for those resistant to antihistamines across all age groups. Further research is warranted to explore the long-term effects of Omalizumab and its potential in personalized CSU management strategies.

Anahtar Kelimeler

• Omalizumab
• Chronic spontaneous urticaria
• Urticaria Activity Score
• Urticaria Control Test
• Chronic Urticaria Quality of Life Questionnaire

Kaynakça

1. 1. Khakoo G, Sofianou-Katsoulis A, Perkin MR, Lack G. Clinical features and natural history of physical urticaria in children. Pediatr Allergy Immunol. Jun 2008;19(4):363-6. doi:10.1111/j.1399-3038.2007.00667.x
2. 2. Zuberbier T, Aberer W, Asero R, et al. The EAACI/GA(2) LEN/EDF/WAO Guideline for the definition, classification, diagnosis, and management of urticaria: the 2013 revision and update. Allergy. Jul 2014;69(7):868-87. doi:10.1111/all.12313
3. 3. Sanchez-Borges M, Asero R, Ansotegui IJ, et al. Diagnosis and treatment of urticaria and angioedema: a worldwide perspective. World Allergy Organ J. Nov 2012;5(11):125-47. doi:10.1097/WOX.0b013e3182758d6c
4. 4. Powell RJ, Leech SC, Till S, et al. BSACI guideline for the management of chronic urticaria and angioedema. Clin Exp Allergy. Mar 2015;45(3):547-65. doi:10.1111/cea.12494
5. 5. Hawro T, Ohanyan T, Schoepke N, et al. The Urticaria Activity Score-Validity, Reliability, and Responsiveness. J Allergy Clin Immunol Pract. Jul-Aug 2018;6(4):1185-1190 e1. doi:10.1016/j.jaip.2017.10.001
6. 6. Bernstein JA, Lang DM, Khan DA, et al. The diagnosis and management of acute and chronic urticaria: 2014 update. J Allergy Clin Immunol. May 2014;133(5):1270-7. doi:10.1016/j.jaci.2014.02.036
7. 7. Zuberbier T, Aberer W, Asero R, et al. The EAACI/GA(2)LEN/EDF/WAO guideline for the definition, classification, diagnosis and management of urticaria. Allergy. Jul 2018;73(7):1393-1414. doi:10.1111/all.13397
8. 8. Baiardini I, Braido F, Bindslev-Jensen C, et al. Recommendations for assessing patient-reported outcomes and health-related quality of life in patients with urticaria: a GA(2) LEN taskforce position paper. Allergy. Jul 2011;66(7):840-4. doi:10.1111/j.1398-9995.2011.02580.x

9. 9. Maurer M, Rosen K, Hsieh HJ, et al. Omalizumab for the treatment of chronic idiopathic or spontaneous urticaria. N Engl J Med. Mar 7 2013;368(10):924-35. doi:10.1056/NEJMoa1215372
10. 10. Saini S, Rosen KE, Hsieh HJ, et al. A randomized, placebo-controlled, dose-ranging study of single-dose Omalizumab in patients with H1-antihistamine-refractory chronic idiopathic urticaria. J Allergy Clin Immunol. Sep 2011;128(3):567-73 e1. doi:10.1016/j.jaci.2011.06.010
11. 11. Chang J, Cattelan L, Ben-Shoshan M, Le M, Netchiporouk E. Management of Pediatric Chronic Spontaneous Urticaria: A Review of Current Evidence and Guidelines. J Asthma Allergy. 2021;14:187-199. doi:10.2147/JAA.S249765
12. 12. Vadasz Z, Tal Y, Rotem M, et al. Omalizumab for severe chronic spontaneous urticaria: Real-life experiences of 280 patients. J Allergy Clin Immunol Pract. Nov-Dec 2017;5(6):1743-1745. doi:10.1016/j.jaip.2017.08.035
13. 13. Tharp MD, Bernstein JA, Kavati A, et al. Benefits and Harms of Omalizumab Treatment in Adolescent and Adult Patients With Chronic Idiopathic (Spontaneous) Urticaria: A Meta-analysis of "Real-world" Evidence. JAMA Dermatol. Jan 1 2019;155(1):29-38. doi:10.1001/jamadermatol.2018.3447
14. 14. Labrador-Horrillo M, Valero A, Velasco M, et al. Efficacy of Omalizumab in chronic spontaneous urticaria refractory to conventional therapy: analysis of 110 patients in real-life practice. Expert Opin Biol Ther. Sep 2013;13(9):1225-8. doi:10.1517/14712598.2013.822484
15. 15. Sussman G, Hebert J, Barron C, et al. Real-life experiences with Omalizumab for the treatment of chronic urticaria. Ann Allergy Asthma Immunol. Feb 2014;112(2):170-4. doi:10.1016/j.anai.2013.12.005
16. 16. Weller K, Groffik A, Church MK, et al. Development and validation of the Urticaria Control Test: a patient-reported outcome instrument for assessing urticaria control. J Allergy Clin Immunol. May 2014;133(5):1365-72, 1372 e1-6. doi:10.1016/j.jaci.2013.12.1076
17. 17. Greaves MW. Pathology and classification of urticaria. Immunol Allergy Clin North Am. Feb 2014;34(1):1-9. doi:10.1016/j.iac.2013.07.009
18. 18. Kaplan AP. Treatment of chronic spontaneous urticaria. Allergy Asthma Immunol Res. Nov 2012;4(6):326-31. doi:10.4168/aair.2012.4.6.326
19. 19. Maurer M, Bindslev-Jensen C, Gimenez-Arnau A, et al. Chronic idiopathic urticaria (CIU) is no longer idiopathic: time for an update. Br J Dermatol. Feb 2013;168(2):455-6. doi:10.1111/j.1365-2133.2012.11171.x
20. 20. Godse K, De A, Zawar V, et al. Consensus Statement for the Diagnosis and Treatment of Urticaria: A 2017 Update. Indian J Dermatol. Jan-Feb 2018;63(1):2-15. doi:10.4103/ijd.IJD_308_17
21. 21. Leznoff A, Sussman GL. Syndrome of idiopathic chronic urticaria and angioedema with thyroid autoimmunity: a study of 90 patients. J Allergy Clin Immunol. Jul 1989;84(1):66-71. doi:10.1016/0091-6749(89)90180-2
22. 22. Vestergaard C, Deleuran M. Chronic spontaneous urticaria: latest developments in aetiology, diagnosis and therapy. Ther Adv Chronic Dis. Nov 2015;6(6):304-13. doi:10.1177/2040622315603951